OBJECTIVE To find out fulminate epidemiological features of Stenotrophomonas maltophilia in ICU and the ways to prevent and treat this nosocomial infection.METHODS The case histories from 4 inpatients who developed S.maltophilia infection in the same ward from Feb 5 to 16,2006,were studied retrospectively to find out the reasons of its onset and its treatment based on the sputum culture results.RESULTS The fulminate S.maltophilia was found from the rail of the patient bed,the connection part of water container of 2 respiratory machines of exhalation valve assembly and the liquid of ultrasonic aeriation machine.CONCLUSIONS The infection is a localized one.The main reasons of the infection are unthorough disinfection of respiratory machine and the contamination of medical treatment environment.Whenever the infection is found in the ward,the thorough disinfection needs immediately,and no new patient admitted.

Aged ; Antigens, CD34 ; analysis ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Solitary Fibrous Tumors ; metabolism ; pathology

To clarify the prognostic contribution of peripheral blood cell and bone marrow megakaryocyte counts in patients with idiopathic thrombocytopenic purpura, a series of data of 299 ITP patients including the counts of peripheral white blood cells and platelets, their increase potentials after treatment and the megakaryocytic counts on the bone marrow smears at diagnosis as well were collected and retrospectively analyzed to correlate with the disease development. The results showed that peripheral white blood cell and platelet counts at diagnosis were not associated with the prognosis, but positively associated with the increment of platelet counts after treatment. The cure rate reached up to 94.9% in the group with the platelet level restored to 100 x 10(9)/L in two weeks of therapy. The numerous megakaryocyte counts in bone marrow at diagnosis indicated good prognosis that the cure rate was up to 86.1% when the counts were more than 100 per 1.5 x 3 cm of smear. In conclusion, bone marrow examination on the quantity and quality of megakaryocyte would be critical for diagnosis and evaluation of the prognosis. Consecutive platelet counts during therapy is useful to estimate the disease development.
Adolescent ; Adult ; Aged ; Bone Marrow Cells ; cytology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukocyte Count ; Male ; Megakaryocytes ; cytology ; Middle Aged ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; blood ; therapy

Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2％ sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations (Fi) and expired concentrations (Fe,Fe≈alveolar concentration [Fa]) of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation (T0-7).Patients were divided into either control group group C) or hyperlipidemia group (group H) according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value (Fa/Fi =0.8) were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H (P ＜ 0.05).Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.

Objective To study the application effect of antiskid steel plate internal fixation via exposing lateral and posterior ankle fracture through fibula posterolateral approach in the treatment of Lauge-Hansen supination-eversion ankle fracture.Methods From January 2009 to December 2012,exposed the lateral and posterior ankle fracture through fibula posterolateral approach of 36 patients suffering from the Lauge-Hansen supination-eversion ankle fracture,and fixed the lateral and posterior ankle by the antiskid steel plate.Adopt Olerud-Molander ankle function scoring system to evaluate the postoperative effect of the ankle.Results All the patients were followed up for 7-27 months,with an average follow-up of 19 months.There was no complications such as incision infection and cutaneous necrosis.Only 1 patient occurred with peroneus myotenositis,and the symptom was relieved after taking out the steel plate.The fracture was healed within 16 weeks.Among the 36 cases,22 cases were excellent,9 cases were good,4 cases were medium and 1 case was poor.The fine rate was 86.1％(31/36).Conclusion Using the antiskid steel plate to treat the lateral and posterior ankle fracture through fibula posterolateral approach,can fully expose a single incision,fix the lateral and posterior ankle and reduce the tension in suture,improve the incision healing rate and fracture stability,provide a new method for treating ankle fracture.

OBJECTIVETo investigate clinical effects of dendritic cells (DCs) pulsed with autologous hepatoma cell lysates on postoperative recurrence and metastasis of hepatocellular carcinoma (HCC).

METHODSDCs isolated from peripheral blood mononuclear cells of HCC patients were cultured and propagated in vitro using rhGM-CSF and rhIL-4, and then were pulsed with autologous hepatoma cell lysates. Thirty postoperative patients with HCC were randomly divided into two groups. Fifteen cases were treated with DC vaccine; fifteen cases received chemotherapy only as a control group. Immune function, clinical effects, hepatic tumor recurrence rate and the survival rate of patients of the two groups were observed and compared.

RESULTSThe levels of CD3+, CD4+/CD8+ and NK cells in the DC vaccine group were significantly increased after vaccination, while those of the control group had no significant changes. The concentration of IL-10 in the DC vaccine group was significantly decreased after the vaccination (P < 0.05). The hepatic tumor recurrence rate at 18 months in the DC vaccine group was 13.33%, compared with 53.33% in the control group (P < 0.05). The survival rate in the former was 93.33%, compared with that of 60% in the later (P < 0.05).

CONCLUSIONHepatoma cell lysates pulsed DC vaccine may improve the immune function of the postoperative HCC patients and play an important role in prevention of postoperative recurrence and metastasis of HCC, which would provide an innovative approach for the immunotherapy of HCC.

Cancer Vaccines ; therapeutic use ; Carcinoma, Hepatocellular ; pathology ; therapy ; Dendritic Cells ; immunology ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; therapeutic use ; Humans ; Immunotherapy ; Interleukin-4 ; therapeutic use ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Metastasis ; prevention & control ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Recombinant Proteins ; therapeutic use

Objective To explore the problems in the introducing of complementary food in infants and provide a guidance for cli nical practice.Methods The questionnaire survey was carried out by childhood health doctors in mothers or caregivers on fixed outpatient health care day. The data of survey was entered into computer and analyzed with SPSS 11.5 software.Results 1.Earlier (

Objective :To study influence of amlodipine combined valsartan on autonomic nervous function and serum level of Rho‐associated protein kinase 1 (ROCK1) in hypertensive patients with renal injury .Methods :A total of 94 hypertensive patients with renal injury treated in our hospital were selected ,randomly and equally divided into amlo‐dipine group and combined treatment group (received amlodipine combined valsartan ) ,both groups were treated for one month .Serum ROCK1 level and autonomic nervous function indexes before and after treatment ,therapeutic effect and incidence of adverse reactions were analyzed and compared between two groups .Results :After treat‐ment ,total effective rate of combined treatment group was significantly higher than that of amlodipine group (95. 74% vs.82.97%,P＝0. 045).Compared with before treatment ,after treatment ,there were significant reduc‐tions in serum ROCK1 level [amlodipine group : (3. 25 ± 0.32 ) ng／ml vs.(1.24 ± 0. 45 ) ng／ml ,combined treat‐ment group :(3. 34 ± 0. 35) ng／ml vs.(0.22 ± 0.15 ) ng／ml] ,24hSBP standard deviation (24hSSD) ,24h DBP SD (24hDSD) ,daytime SBP SD (dSSD) ,nighttime SBP SD (nSSD) and nDSD in two groups ( P＝0.001 all) ,and a‐bove indexes of combined treatment group were significantly lower than those of amlodipine group , P＜ 0. 01 all. Compared with amlodipine group after treatment ,there were significant reductions in incidence rates of lower limb edema (27. 66% vs.10.63%) ,nausea and vomiting (27. 66% vs.8.51%) and dizziness and weakness (23. 40% vs. 8.51%) in combined treatment group ,P＜0. 05 all.Conclusion :Amlodipine combined valsartan possesses significant therapeutic effect on hypertensive patients with renal injury .It can significantly reduce serum ROCK1 level and im‐prove autonomic nervous function and prognosis in these patients .

Objective To study the biological activities of Synechococcus sp.PCC7942 with trans-mutated hCu,Zn-SOD-gene.Methods Synechococcus sp.PCC7942 with trans-mutated hCu,Zn-SOD were administered orally for 20d to mice,then the activities of glutathione peroxidase(GSH-Px),catalase(CAT),superoxide dismutase(SOD) and the content of malondialdehyde(MDA) were determined.Results The activities of GSHPx in serum and the activities of CAT in blood increased obviously;the activity of SOD in serum and liver increased markedly;the content of MDA in serum and liver decreased obviously.Conclusion Synechococcus sp.PCC7942 with trans-mutated hCu,Zn-SOD-gene had obvious antioxidant effect in vivo.

The applicator therapy is a unique method to treat infant diarrhea in traditional Chinese medicines and widely applied in clinical practice. Currently, many researchers have proved the rationality of the therapy based on the traditional Chinese medicine mechanism and on the data from clinical practice, but its action mechanism is uncertain at present. In this study, with the assistance of pediatric practitioners, the automated ribosomal intergenic-spacer analysis (ARISA) was adopted to study the effect of the adjuvant therapy with Dingguier umbilical paste on intestinal flora of diarrhea infants, in which Dingguier umbilical paste served as the adjuvant therapy in oral traditional Chinese medicines and fecal samples of infants with different diarrhea symptoms were collected and used as the study materials. The results showed that the adjuvant therapy had a significant effect on the shift of intestinal flora, which was associated with the decrease in the similarity difference to the normal control group and the increase in the number of operational taxonomic units (OTUs) shared with the normal control group. Additionally, adjuvant therapy with Dingguier umbilical paste also showed long action duration and increased OTUs number. These results indicated that Dingguier umbilical paste has the effect in restoring the micro-ecosystem of unbalanced intestinal bacteria. Intestinal flora may be one of major targets for the applicator therapy for the infant diarrhea, but not for the single oral traditional Chinese medicine for infant diarrhea.
Adjuvants, Pharmaceutic ; therapeutic use ; Diarrhea ; drug therapy ; microbiology ; Feces ; microbiology ; Female ; Humans ; Infant ; Intestines ; drug effects ; microbiology ; Male ; Medicine, Chinese Traditional ; methods ; Ointments ; Treatment Outcome ; Umbilicus